Fourth metacarpal fracture and dislocated fifth carpometacarpal joint

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Punch injury.

Patient Data

Age: 20 years
Gender: Male

Transverse, volar angulated fracture of the proximal shaft of the 4th metacarpal. The 4th CMC joint is normally aligned. 

Dorsal dislocation of the 5th CMC joint. The curvilinear osseous fragment projected between the bases of the 4th and 5th metacarpals suggests an associated fracture, likely from the volar aspect of the base of the 5th metacarpal.

Case Discussion

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